Fri Mar 18 2022

108 articles - From Saturday Mar 12 2022 to Friday Mar 18 2022

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…

Aliment Pharmacol Ther

A United States expert consensus to standardise definitions, follow-up, and treatment targets for extra-intestinal manifestations in inflammatory bowel disease.

Consensus criteria for appropriate and optimal means of diagnosing and monitoring five EIMs have been developed as a starting point to inform clinical practice and future trial design. Key findings include straightforward diagnostic criteria, guidance regarding who can appropriately and optimally diagnose each, and monitoring options that include patient and physician-reported outcomes. These findings will be used in a national multicenter study network to optimise the management of EIMs.

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Am J Gastroenterol

American College of Gastroenterology-Canadian Association of Gastroenterology Clinical Practice Guideline: Management of Anticoagulants and Antiplatelets During Acute Gastrointestinal Bleeding and the Periendoscopic Period.

With acute GI bleeding in patients on warfarin, we could not recommend for or against PCC administration when compared with placebo. In the elective periprocedural endoscopy setting, we could not recommend for or against temporary interruption of the P2Y12 receptor inhibitor for patients on a single P2Y12 inhibiting agent. We were also unable to make a recommendation regarding same-day resumption of the drug vs 1-7 days after the procedure among patients prescribed anticoagulants (warfarin or DOACs) or P2Y12 receptor inhibitor drugs because of insufficient evidence.

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Meta-analysis

meta-analyses and systematic reviews

Aliment Pharmacol Ther

Meta-analysis: analysis of mechanistic pathways in the treatment of non-alcoholic steatohepatitis. Evidence from a Bayesian network meta-analysis.

This network analysis demonstrates the relative superiority of drugs modulating energy pathways and bile acids in NASH treatment. This guides the development and selection of drugs for combination therapies.

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Meta-analysis: Prevalence of, and risk factors for, non-alcoholic fatty liver disease in patients with inflammatory bowel disease.

Up to one-third of patients with IBD experienced NAFLD worldwide. The risk of NAFLD was two times higher in IBD patients versus healthy subjects.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Defining normal pouch function in patients with ileal pouch-anal anastomosis: a pilot study.

A substantial proportion of patients with IPAA and self-reported healthy pouch function have anatomic and/or functional abnormalities of the pouch. In asymptomatic IPAA patients with an anatomically normal pouch, we have proposed normal parameters for high-resolution ano-pouch manometry, time to balloon expulsion, pouch barostat, and MR defecography.

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Lower effectiveness of intravenous steroid treatment for moderate-to-severe ulcerative colitis in hospitalised patients with older onset: A multicentre cohort study.

Older-onset was associated with a lower effectiveness of intravenous steroids with higher risks of surgery and adverse events in UC.

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Mild neoterminal ileal post-operative recurrence of Crohn's disease conveys higher risk for severe endoscopic disease progression than isolated anastomotic lesions.

Post-operative ileal disease recurrence, not isolated anastomotic inflammation, confers increased risk for severe endoscopic disease progression. Location of CD recurrence may impact optimal management strategies.

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Am J Gastroenterol

2021 National Survey on Prior Authorization Burden and Its Impact on Gastroenterology Practice: ACG Prior Authorization Survey.

PA is an administrative burden that exhausts practice resources and may have a negative impact on patient care.

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A Smartphone Application Using Artificial Intelligence Is Superior to Subject Self-Reporting When Assessing Stool Form.

A novel smartphone application can determine BSS and other visual stool characteristics with high accuracy compared to 2 expert gastroenterologists. Moreover, trained AI was superior to subject self-reporting of BSS. AI assessments could provide more objective outcome measures for stool characterization in gastroenterology.

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Clinical indication of aspirin associated with reduced risk of liver cancer in chronic hepatitis B: A nationwide cohort study.

Long-term aspirin use is significantly associated with reduced risk of HCC in chronic HBV patients. More comprehensive studies should be implemented to clarify the causal relationship.

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Dietary Vitamin E intake is associated with a reduced risk of developing digestive diseases and NAFLD.

Our findings reveal the relevance of Vitamin E consumption for several gastrointestinal diseases and warrant further mechanistic and therapeutic investigations.

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Infliximab Is Not Associated With a General Long-Term Weight Gain in Patients With Inflammatory Bowel Disease: A Nationwide Study.

Weight gain among patients treated with anti-TNF-a therapies is unlikely to be due to an effect from anti-TNF-a therapy.

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Optimal design of clinical trials of dietary interventions in disorders of gut-brain interaction.

Collaboration with experts in nutrition and dietetics is essential for the planning phase however even with expert input not al challenges can be overcome. Researchers undertaking future dietary trials must be transparent in reporting these challenges and approaches for overcoming them. This review aims to provide guiding principles and recommendations for addressing these challenges to facilitate the conduct and reporting of high-quality trials that inform and improve clinical practice.

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PHARMACODYNAMICS AND PHARMACOKINETICS OF THE POTASSIUM-COMPETITIVE ACID BLOCKER VONOPRAZAN AND THE PROTON PUMP INHIBITOR LANSOPRAZOLE IN U.S. SUBJECTS.

Vonoprazan provided more rapid and potent inhibition of intragastric acidity than lansoprazole in U.S. subjects.

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Clin Gastroenterol Hepatol

Development and external validation of a model to predict complex treatment after RFA for Barrett's esophagus with early neoplasia.

We developed a prognostic model that identified patients with BE length =9cm and HGD/EAC and those with poor squamous regeneration as high-risk for a complex treatment course. The good performance in external validation suggests that it may be used in clinical management (NTR NL7039).

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Early symptomatic improvement after ustekinumab therapy in patients with ulcerative colitis: 16-week data from the UNIFI trial.

Ustekinumab improved symptoms in patients with UC compared with placebo in as early as 7 days, indicating rapid onset of effect after induction. Clinical trial registry number and url ClinicalTrials.gov NCT02407236;

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Impact of type 2 diabetes on the accuracy of non-invasive tests of liver fibrosis with resulting clinical implications.

The decrease in NIT accuracy observed in T2DM is partly biased by the different characteristics of the groups studied, but also linked to T2DM itself through modification of the levels of some NIT biomarkers. Specialized tests should be used first-line to diagnose advanced liver fibrosis in T2DM.

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Endoscopy

A deep learning-based system for real-time image reporting during esophagogastroduodenoscopy: a multicenter study.

The EAIRS can generate qualified image reports and could be a powerful tool for generating endoscopic reports in clinical practice.

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Detection of Barrett's Neoplasia with Near-infrared Fluorescent Heterodimeric Peptide.

This "first-in-human" clinical study demonstrates feasibility to detect early Barrett's neoplasia using a NIR-labeled peptide heterodimer.

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Gastroenterology

Pediatric Extrapolation Of Adult Efficacy to Children Is Critical for Efficient and Successful Drug Development.

The unmet need of children with IBD necessitates the discussion and consideration of more broad application of a critical global regulatory concept of pediatric extrapolation. Drug development in pediatric IBD, leading to labeling and market authorization, should be based on extrapolation of adult efficacy data with PK exposure matching and similar PD (endoscopic endpoint) findings, as compared to adult exposure and efficacy assessments. Additional efficacy and safety data should be obtained through a combination of post-marketing long term extension studies, real world evidence and extrapolation of safety from other immunologic indications.

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Postprandial plasma lipidomics reveal specific alteration of hepatic-derived diacylglycerols in non-alcoholic fatty liver disease.

We identified a selective insulin-related increase in hepatic secretion of endogenously-derived DAGs after a mixed meal as a unique feature of NAFLD. DAGs are known to be lipotoxic and associated with atherosclerosis. While it is still unknown whether the increased exposure to hepatic DAGs contributes to extrahepatic manifestations and cardiovascular risk in NAFLD, our study highlights the importance of extending NAFLD research beyond the fasting state.

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Gastrointest Endosc

Analysis of metastases rates during follow-up after endoscopic resection of early "high-risk" esophageal adenocarcinoma.

Whereas the annual metastasis rate for high-risk submucosal EAC (3.0%) was somewhat lower than expected in comparison with previous reported percentages, the annual metastasis rate of 6.9% for high-risk intramucosal EAC is new and worrisome. This calls for further prospective studies and suggests that strict follow-up of this small subgroup is warranted until prospective data are available.

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Clinically Significant Serrated Polyp Detection Rates and Risk for Post Colonoscopy Colorectal Cancer: Data From the New Hampshire Colonoscopy Registry.

Our study is the first to demonstrate a lower PCCRC risk following exams performed by endoscopists with higher CSSDR. Both CSSDR of 9% and 3 - < 9% had statistically lower risk of PCCRC than CSSDR of < 3 %. These data validate CSSDR as a clinically relevant quality measure for endoscopists.

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Cold versus hot snare resection with or without submucosal injection of 6-15 mm colorectal polyps: a randomized controlled trial.

Cold snaring is a dominant resection technique for non-pedunculated colorectal lesions 6-15 mm in size.

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Improving the Tolerability and Safety of 1L Polyethylene Glycol Plus Low-dose Ascorbic Acid for Bowel Preparation in a Healthy Population: A Randomized, Multicenter Clinical Trial.

1L PEG with low-dose ASC (25%-50% reduction in dose) for bowel cleansing showed similar efficacy and safety compared with standard 1L or 2L PEG-ASC, better tolerability compared with 2L PEG-ASC, and less residual gastric fluid retention compared with standard1L PEG-ASC.

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Hepatology

Accurate Long-Term Prediction of Death for Patients with Cirrhosis.

We developed and validated (internally and externally) a risk score to predict longer-term survival of patients with cirrhosis. This score would transform management of patients with cirrhosis in terms of referral to specialty care and treatment decision-making for non-liver related care.

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CCL5 confines liver regeneration by downregulating reparative macrophage-derived HGF in an FoxO3a dependent manner.

Our findings suggest that inhibition of CCL5 is a promising strategy to improve regeneration restoration by enhancing HGF secretion from reparative macrophages via FoxO3a pathway, which may potentially reduce the mortality of post-hepatectomy liver failure.

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Immunocompromised rabbit model of chronic hepatitis E reveals liver fibrosis and distinct efficacy of different vaccination strategies.

The immunocompromised rabbit model of both chronic HEV3 and HEV4 infection that was established captured the key features of chronic HEV infection in transplant patients, including liver fibrogenesis, and revealed the distinct effectiveness of vaccination administered prior to or under immunosuppression. This rabbit model is valuable for understanding the pathogenesis of chronic hepatitis E, as well as for evaluating antiviral agents and vaccines.

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Improving the model for end-stage liver disease with sodium by incorporating kidney dysfunction types.

This study demonstrates the feasibility and the potential for objectively-defined kidney dysfunction types to enhance the prognostication of waitlist mortality provided by the MELDNa score.

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Portal fibroblasts with mesenchymal stem cell features form a reservoir of proliferative myofibroblasts in liver fibrosis.

PMSCs form a small reservoir of expansive myofibroblasts, which in interaction with neo-vessels and HSC-MFs that mainly arise via differentiation from a preexisting pool, underlie the formation of fibrotic septa in al types of liver diseases.

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Inflamm Bowel Dis

Artificial Intelligence Program to Predict p53 Mutations in Ulcerative Colitis-Associated Cancer or Dysplasia.

Our trained CNN can be used as a reasonable alternative to conventional p53 immunohistochemical staining in the pathological diagnosis of colitis-associated neoplasia, which is accurate, saves time, and is cost-effective.

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Prognostic Value of Colonic Tissue and Blood Eosinophils in Ulcerative Colitis.

Baseline tissue or peripheral blood eosinophils are not markers of disease activity and cannot be used as a predictor of severe disease outcomes in both adults and children with UC.

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J Crohns Colitis

Pre and perinatal factors predicting Inflammatory Bowel Disease - a population-based study with fifty years follow-up.

This population-based study identifies several pre and perinatal variables as predictors of IBD development. This information may be helpful to facilitate implementation of early diagnosis interventions and family follow-up protocols.

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J Hepatol

Loss of SIRT5 promotes bile acid-induced immunosuppressive microenvironment and hepatocarcinogenesis.

This study uncovers a novel function of SIRT5 in orchestrating BA metabolism to prevent tumor immune evasion and suppress HCC development. Our results also suggest a potential strategy of using clinically proven BA sequestrants for the treatment of HCC patients, especially those with decreased SIRT5 and abnormally high BAs.

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Past COVID-19 and immunosuppressive regimens affect the long-term response to anti-SARS-CoV-2 vaccination in liver transplant recipients.

In COVID-19-naïve, the immunogenicity of anti-SARS-CoV-2 vaccination was significantly lower than that in controls. MMF was the main determinant of vaccination failure in SARS-CoV-2 naïve patients.

Pubmed   Journal   ReadQx   PMC

Role of XBP1 in regulating the progression of non-alcoholic steatohepatitis.

XBP1 regulates the development of NASH. XBP1 inhibitors protect against steatohepatitis. XBP1 thus is a potential target for the treatment of NASH.

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Transcriptional switch of hepatocytes initiates macrophage recruitment and T cell suppression in endotoxemia.

Our study elucidates unanticipated aspects of the cellular and molecular effects on liver cells in endotoxemia at the single-cell level and provides a conceptual framework for the development of novel therapeutic approaches for acute infection.

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Neurogastroenterol Motil

Comparison of commercially available antibodies for the detection of phosphorylated alpha-synuclein in primary culture of ENS.

Using D1R1R antibody together with the optimized protocol for membrane fixation may help deciphering the signaling pathways involved in enteric alpha-synuclein post-translational regulation in PD.

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Effect of percutaneous electrical nerve field stimulation on mechanosensitivity, sleep, and psychological comorbidities in adolescents with functional abdominal pain disorders.

We demonstrated improvements in resting and evoked pain and nausea, sleep, disability, pain catastrophizing, somatic complaints, and anxiety after four weeks of PENFS therapy. Some effects were sustained at 6-12 months post-treatment. This suggests that PENFS is a suitable alternative to pharmacologic therapy.

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Overlap of heartburn, functional dyspepsia, and irritable bowel syndrome in a population sample: Prevalence, temporal stability, and associated comorbidities.

Overlap between IBS, FD, and heartburn (GERD) appears to be a distinct entity that has a profile including psychological morbidity, sleep disturbance, and elevated rates of atopy.

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Pediatric Rome IV diagnosis agreement is greater than agreement on diagnostic testing.

In a multicenter evaluation among pediatric gastroenterology physicians, pediatric Rome IV diagnostic agreement was higher than that reported for previous Rome versions, and higher than agreement on diagnostic testing.

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Tamoxifen administration alters gastrointestinal motility in mice.

Our findings highlight the importance of considering GI motility alterations induced by tamoxifen when designing protocols that utilize tamoxifen as a Cre-driver for studying GI function.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Review article: emerging insights into the immunopathology, clinical and therapeutic aspects of hepatitis delta virus.

The HBV cure programme potentially offers a unique opportunity to enhance HDV treatment strategies. In addition, a more comprehensive analysis of the intrahepatic compartment is mandated to better understand any liver-confined interaction of HDV with the host immune system.

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Clin Gastroenterol Hepatol

Farewell from the Outgoing CGH Board of Editors.

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Gastroenterology

Genetic Predisposition for Helicobacter pylori Infection-The Jury Is Still Out!

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Our New President-John M. Carethers, MD, AGAF.

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Pregnancy-Associated Liver Diseases.

Their importance lies in the significant maternal and fetal/neonatal morbidity and mortality. Expeditious diagnosis and clinical evaluation is critical to ensure timely, appropriate care and minimize risks to the pregnant woman and her fetus/baby. A multidisciplinary approach is critical including midwives, maternal-fetal-medicine specialists, anaesthetists, neonatologists and hepatologists.

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Why Is Cancer of the Small Intestine Increasing?

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Gastrointest Endosc

Connecting the dots to eliminate recurrence after endoscopic mucosal resection in the colon.

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Electrohydraulic lithotripsy pancreatoscopy: Crush and remove stones-yes! Help our patients-maybe?

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ERCP in the evaluation of biliary strictures: Tissue is the issue! Is FISH the answer?

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Evolution and Evidence-Based Adaptations in Techniques for Per-oral Endoscopic Myotomy for Achalasia.

While myotomy length for Type 1 and Type 2 achalasia has classically been >6 cm, recent studies demonstrate similar outcomes with reduction of myotomy length to <3cm. Length of myotomy for type 3 achalasia has been tailored to treat the entire length of spastic muscle segment, and the modality to gauge the optimal thickness and length of myotomy in this group has yet to be established. In addition to changes in POEM technique, the post-operative management of POEM has also changed, favoring reduced post-procedure imaging, antibiotic use, and hospitalizations.

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Quality assessment in screening colonoscopy: a computer will be watching you.

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When it comes to continuous measurement of colonoscopy quality, patient survival is mandatory.

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Gut

Cancer pharmacomicrobiomics: targeting microbiota to optimise cancer therapy outcomes.

We further discuss the current limitations of gut microbiota modulation in patients with cancer and suggest essential directions for future study. In the era of personalised medicine, it is crucial to understand the microbiota and its interactions with cancer. Manipulating the gut microbiota to augment cancer therapeutic responses can provide new insights into cancer treatment.

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Hepatology

Many roads lead to Rome: The FGF4-AMPK-Caspase 6 signal axis in NAFLD and NASH.

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Neurogastroenterol Motil

Aging of enteric neuromuscular systems in gastrointestinal tract.

There is also evidence that the aging contributes to phenotypic changes in innate immune cells, which are physically and functionally linked to other cells in the tunica muscularis and can alter GI (patho) physiology. However, various patterns of changes have been reported, some of which are contradictory, indicating a need for additional work in this area. Purpose Although GI infection due to intestinal bacterial overgrowth, bleeding, and cancers are also important and common problems in the elderly patients, this mini-review focuses on data obtained from enteric neuromuscular aging research with the goal of better understanding the cellular and molecular mechanisms of enteric neuromuscular aging to enhance future therapy.

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Long-term personalized low FODMAP diet in IBS.

However, concerns have been raised as restricting fermentable carbohydrates might result in nutritional deficits or alter composition and function of the gut microbiome in the long term. The study by Staudacher et al., published in this issue of the journal, is the first prospective study to follow IBS patients after completing al three phases of the low FODMAPs diet (restriction, reintroduction, and personalization), demonstrating that this is safe and effective in long-term, when patients are supervised by a dietician. This mini-review provides an up-to-date overview of the use of fermentable carbohydrate's restrictions for symptom management in IBS patients, while summarizing the current knowledge on the possible mechanisms of action behind low fermentable carbohydrate diet efficacy.

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Letters&Replies

Letters to the editors and authors’ replies

Clin Gastroenterol Hepatol

Does NAFLD prevalence data expire?

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RE: Poor response to inactivated SARS-CoV-2 vaccine in patients with chronic liver disease.

Pubmed   Journal   ReadQx   PMC

Reply to Letter to Editor.

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Transnasal Endoscopy: Seeing is Believing.

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Gastroenterology

Should we continue or discontinue inflammatory bowel disease medication in patients with COVID-19?

Pubmed   Journal   ReadQx   PMC

Gut

Improved NGS variant calling tool for the PRSS1-PRSS2 locus.

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Hepatology

Letter to the Editor.

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J Hepatol

Association of rectal colonisation by MDROs with new infection in cirrhosis.

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Autoimmune hepatitis and COVID-19: No increased risk for AIH after vaccination but reduced care.

Pubmed   Journal   ReadQx   PMC

Protection against acetaminophen-induced liver injury with MG53: muscle-liver axis and necroptosis.

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Reply to: "Comment on Exposure to air pollution is associated with an increased risk of metabolic dysfunction-associated fatty liver disease".

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Reply to: "Correspondence on the ".

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Reply to: "Is it safe to treat chronic hepatitis C patients with decompensated cirrhosis with PI-based DAA?"

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Risk stratification of hepatocellular carcinoma after hepatitis C virus eradication in patients with compensated advanced chronic liver disease in Japan.

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Unexplained liver test elevations after SARS-CoV-2 vaccination.

Pubmed   Journal   ReadQx   PMC


Others

all remaining publications eg case reports, images of the month, etc…

Am J Gastroenterol

Abdominal Wall Invasion of Hepatocellular Carcinoma.

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Cecal Bascule: A Flip for the Worse.

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Excellent performance from the novel utility of external cannula in patients with poor gastrointestinal preparation.

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Increasing the Yield: When More is Better.

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Large Gastric Pyloric Gland Adenoma.

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Over-the-wire Lumen Apposing Metal Stent exchange for management of a long-term Choledocho-Duodenostomy dysfunction.

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Pancreatic Duct Small-Caliber Plastic Stenting Using a Molting Technique Under Endoscopic Retrograde Cholangiopancreatography Guidance.

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The current knowns and unknowns of COVID-19 vaccine induced immunity in patients with inflammatory bowel disease.

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The development of colon adenocarcinoma on a ganglioneuroma in a patient with nonhereditary disease.

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Clin Gastroenterol Hepatol

Texture and Color Enhancement Imaging with Indigo Carmine Dye Accentuates Slightly Depressed Early Gastric Cancer Lesions.

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The Risk of Hepatocellular Carcinoma in Entecavir versus Tenofovir Treated U.S. Cohort with Chronic Hepatitis B Virus.

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Endoscopy

A forethought about obscure gastrointestinal bleeding: an unusual ileal mass.

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Cholangioscopic appearance of circular folds in immune-related adverse event cholangitis.

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Colocolonic intussusception identified during endoscopy: an incidental diagnosis.

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Double-band ligation-assisted endoscopic submucosal resection for type 1 gastric neuroendocrine tumor with type A gastritis.

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Endoscopic findings of paraduodenal or groove pancreatitis.

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Endoscopic full-thickness resection of a duodenal gastrointestinal stromal tumor with extraluminal component: the usefulness of traction and sutures.

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Endoscopic management of buried bumper syndrome: the balloon-dilation pull technique.

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Endoscopic removal of a migrated esophageal covered self-expandable metal stent: the nylon loop pusher-assisted method.

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Endoscopic sinusotomy using the small-ceramic-tip-insulated electrosurgical knife for chronic pouch sinus after ileal pouch anal anastomosis in ulcerative colitis: a case report.

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Endoscopic submucosal dissection of a solitary gastric plasmacytoma: "third space oddity".

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IgG4-related sclerosing cholangitis involving the gallbladder mimicking a hilar cholangiocarcinoma.

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Successful resection of a 22-cm subcircumferential rectal lesion treated by endoscopic submucosal dissection with a mucosal-anchor-assisted multiple-tunnel method.

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To an ecological endoscopic submucosal dissection: tips and tricks to reduce waste.

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Gastroenterology

Disparities persist in inclusion of female, pregnant, lactating, and older individuals in inflammatory bowel disease clinical trials.

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Gender, Age, Racial and Ethnic Disparities in Clinical Trial Enrollment for Primary Liver Cancer.

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Precision Medicine in Inflammatory Bowel Diseases: Challenges and Considerations for the path forward.

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Protocol standardization of microbiome studies - daunting but necessary.

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Rising incidence and racial disparities of early-onset pancreatic cancer in the United States, 1995-2018.

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Wild-type human PRSS2 and PRSS1R122H cooperatively initiate spontaneous hereditary pancreatitis in transgenic mice.

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Hepatology

Dr. Joseph R. Bloomer: In Remembrance.

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Hepatology Highlights.

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Inflamm Bowel Dis

Positive Gluten Sensitivity Serologies and the Impact of Gluten-free Diet in Patients With IBD.

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Self-Reported Failure to Address Sexual Function in Patients With Inflammatory Bowel Disease by Gastroenterologists: Barriers and Areas for Improvement.

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Synchronous Multifocal Adenomatous Dysplasia and Post-transplant Lymphoproliferative Disorder Confined to the Colon in a Patient with Ulcerative Colitis After Liver Transplant.

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